At any given moment, about one in five employees in an organization suffers from too much stress in dealing with personal problems, and this can affect job performance — unless some sort of intervention takes place. One such means of intervention is the employee assistance program (EAP).

While many employers who still restrict their benefits plans to traditional group benefits, this attitude is changing. In a recent survey on employee benefits costs in Canada, it was found that approximately 34% of employees and their family members were provided with access to EAPs.

The increasing professional and personal demands of modern-day living have given rise to non-traditional employee benefits, such as "employee assistance" and "wellness" programs, that are designed to address employee health and well-being. The concept behind both programs is that a happier and healthier employee is a more productive employee and one who is less likely to use disability and health care benefits.

Troubled employees are prone to increased absenteeism and reduced productivity and they also have more serious on-the-job accidents. This, in turn, drives up the costs of health and disability benefits, lowers employee morale since co-workers are forced to pick up the slack and increases staff turnover, which has a negative impact on the employer's bottom line.

Alternatively, an employee who uses an EAP may be able to bring job performance back into line. In addition, use of an EAP prevents a covered person's physical and mental condition from deteriorating to the point where they have to claim for health care benefits and (for employees only) short-term disability and long-term disability benefits. An EAP is no longer viewed as a fringe benefit, but has become a major component within a comprehensive program to control benefit expenditures and to improve employee health. Confidence in the efficacy of EAPs is so strong that some insurance companies offer discounted long-term disability rates to those employers who offer their employees EAPs.

Fundamentals of an EAP

An EAP is a program of systematic interventions in the workplace that is designed to:

Promote health in the workplace, using a wide range of health promotion strategies aimed at employees who have little risk of personal problems affecting their job performance;

Provide covered persons who are just beginning to experience personal difficulties with some means to voluntarily access needed care or assistance; and

Provide employers with an alternate option to the organization's normal disciplinary procedures for dealing with employees whose job performance is at an unacceptable level due to a serious problem and who may be unwilling, or unable, to take advantage of preventive resources.

EAPs assist the employer, the employee and the employee's dependants. They can be accessed voluntarily by the employees dealing with problems that have not yet affected job performance. As well, an EAP provides employers with an alternative to solving job performance problems and, in many cases, saves otherwise productive and talented employees.

Traditionally, the responsibility for dealing with an employee's problems fell on the individual employee, the employee's immediate family or on community resources. Today, government cost-shifting has left many gaps in this support. Employers, recognizing the potential negative impact on productivity and, ultimately, the bottom line, are increasingly willing to help employees deal with their problems.

As the following statistics illustrate, it makes good business sense to provide EAPs:

An estimated 10% to 20% of Canadian workers abuse alcohol and drugs, which creates problems that cost businesses between one billion and three billion dollars each year; and

Emotional problems account for 20% to 30% of employee absenteeism and up to 50% of industrial accidents

An EAP can be provided in one of two ways. Large employers prefer to develop their own EAP, providing an on-site program that operates through an employer's human resources department or occupational health and safety department. Alternately, many employers consider it more cost-effective to implement an off-site EAP. With the emergence of specialty providers and health care networks that specialize in developing EAPs, off-site programs can adequately service employers by offering covered persons access to a wide range of services without the employer having to absorb the necessary start-up and overhead costs of developing an in-house program.

Wellness Programs
An increasingly popular addition to EAPs are wellness programs that aim to educate workers about controllable lifestyle health risks and to promote health and fitness through programs focusing on fitness and exercise, nutrition and weight management, smoking cessation and stress management.

Plan Design

There are four basic types of services that should be included in an EAP:

Crisis intervention, which includes 24-hour toll-free hotlines 365 days a year and telephone counseling services, drop-in centres and self-help groups, such as Alcoholics Anonymous;

Outpatient services, which include assessment, diagnosis, information, education and ongoing treatment for a variety of problems most likely to arise in a particular workplace. Services include counseling on marital and mental health problems and alcohol and drug dependencies;

Inpatient services, which provide intensive treatment for employees with severe problems. Treatment is provided to stabilize the problem until long-term help can be put into place; and

Self-help groups, which each focus on a specific problem and which are set up and operated by individuals who have overcome a similar problem, in order to provide ongoing support in coping with problems such as alcoholism and divorce. Self-help groups should not replace needed professional treatment.

There are a broad number of categories of problems that are open to treatment under an EAP, such as:

marital problems

mental health problems

alcohol and drug dependency

personal and emotional concerns

single-parent issues

elder-care issues

stress and anxiety

poor personal or work relationships

financial issues

legal issues

trauma response services

Formalizing and publishing policies and procedures is essential for the success of an EAP as it clarifies both the responsibilities of the employees and the employer. A comprehensive document should include:

Mission Statement

At the very inception of an EAP, it should be well communicated that the program is designed to assist employees with problems affecting their job performance, but that the employee is still responsible to perform at an acceptable level. Employees must understand that the use of an EAP will not shield them from disciplinary action, where required, nor will use of an EAP hurt their job security or chances for promotion.

Statement of Confidentiality

This is essential at every stage in the use of an EAP. No one other than those involved with assisting the employee should be made aware of the employee's problem.

Confidentiality

Perhaps, the most important feature of an EAP is confidentiality. Not even the most comprehensive EAP will attract employees if there is any indication that an employee's problems and the services they will use will not be kept confidential. Few employees, if any, will use an EAP if there is fear of reprisals or an invasion of privacy. Without confidentiality, the EAP will lose credibility and will not be viable.

The names of employees are not released to the employer. Every aspect of the referral process is conducted by professionals who are bound by confidentiality rules. Any information about the employee's progress under treatment is governed by legislation protecting an individual's right to privacy and that allows release of information only with the employee' consent. Information that is released to an employer is strictly statistical program utilization data, such as the age of plan users, the services used, the frequency of usage, the number of cases resolved and the types of personal problems for which assistance is sought. In addition, effective programs formalize their policies and publish them, communicate them to employees, while demanding that the EAP staff strictly follow confidentiality procedures.

The delivery of the key components of EAPs is instrumental in the success of any program. In summary, these key components are: